The Incidence of Acute Respiratory Infections in Children who Have Undergone Critical Conditions in the Neonatal Period, Depending on the Severity оf Organ Dysfunction. Retrospective Cohort Study

Abstract Background. Live vaccines may have nonspecific beneficial effects on morbidity and mortality. This study examines whether children who had the live-attenuated oral polio vaccine (OPV) as the most recent vaccine had a different rate of admissions for infectious diseases than children with inactivated diphtheria-tetanus-pertussis-polio-Haemophilus influenzae type b vaccine (DTaP-IPV-Hib) or live measles-mumps-rubella vaccine (MMR) as their most recent vaccine. Methods. A nationwide, register-based, retrospective cohort study of 137 403 Danish children born 1997–1999, who had received 3 doses of DTaP-IPV-Hib, were observed from 24 months (first OPV dose) to 36 months of age. Results. Oral polio vaccine was associated with a lower rate of admissions with any type of non-polio infection compared with DTaP-IPV-Hib as most recent vaccine (adjusted incidence rate ratio [IRR], 0.85; 95% confidence interval [CI], .77–.95). The association was separately significant for admissions with lower respiratory infections (adjusted IRR, 0.73; 95% CI, .61–.87). The admission rates did not differ for OPV versus MMR. Conclusions. Like MMR, OPV was associated with fewer admissions for lower respiratory infections than having DTaP-IPV-Hib as the most recent vaccination. Because OPV is now being phased-out globally, further studies of the potential beneficial nonspecific effects of OPV are warranted.

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High-dose colistin for microbiologically documented serious respiratory infections associated with carbapenem-resistantAcinetobacter baummanniiin critically ill cancer patients: a retrospective cohort study

Infectious Diseases ◽

10.3109/23744235.2015.1055586 ◽

2015 ◽

Vol 47 (11) ◽

pp. 755-760 ◽

Cited By ~ 7

Author(s):

Lama H. Nazer ◽

Sweilem Rihani ◽

Feras I. Hawari ◽

Jennifer Le

Keyword(s):

Cohort Study ◽

Cancer Patients ◽

Critically Ill ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Respiratory Infections ◽

High Dose

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Association Between Afterhours Discharge From the Intensive Care Unit and Hospital Mortality: A Multi-Center Retrospective Cohort Study

Journal of Intensive Care Medicine ◽

10.1177/0885066620981902 ◽

2021 ◽

pp. 088506662098190

Author(s):

Adam Hall ◽

Xioaming Wang ◽

Danny J. Zuege ◽

Dawn Opgenorth ◽

Damon C. Scales ◽

...

Keyword(s):

Intensive Care Unit ◽

Cohort Study ◽

Intensive Care ◽

Hospital Mortality ◽

Organ Dysfunction ◽

Sofa Score ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Mixed Effect ◽

Icu Discharge

Background: There is conflicting evidence on the association between afterhours discharge from the intensive care unit (ICU) and hospital mortality. We examined the effects of afterhours discharge, including the potential effect of residual organ dysfunction, on hospital mortality in a large integrated health region. Methods: We performed a multi-center retrospective cohort study of 10,463 adults discharged from 9 mixed medical/surgical ICUs in Alberta from June 2012 to December 2014. We applied a 2-stage modeling strategy to investigate the association between afterhours discharge (19:00h to 07:59h) and post-ICU hospital mortality. We applied mixed-effect multi-variable linear regression to assess the relationship between discharge organ dysfunction and afterhours discharge. We then applied mixed-effect multi-variable logistic regression to evaluate the direct, indirect and integrated associations of afterhours discharge on hospital mortality and hospitalization duration. Results: Of 10,463 patients, 23.7% (n = 2,480) were discharged afterhours, of which 27.4% occurred on a holiday or weekend. This varied significantly by ICU size, type, and site. Patients discharged afterhours were more likely medical admissions, had greater multi-morbidity and illness acuity. A greater average SOFA score in the 72 hours prior to ICU discharge was not associated with afterhours discharge. However, a greater average SOFA score was associated with hospital mortality (adjusted-odds ratio [OR], 1.23; 95% CI, 1.18-1.28). Afterhours discharge was associated with higher hospital mortality (adjusted-OR, 1.19; 95% CI, 1.01-1.39), increased hospital stay (adjusted-risk ratio [RR], 1.10; 95% CI, 1.09-1.11) and increased post-ICU stay (adjusted-RR, 1.16; 95% CI, 1.14-1.17) when compared with workhours discharge. Conclusions: Afterhours discharge is common, occurring in 1 in 4 discharges, and is widely variable across ICUs. Patients discharged afterhours have greater risk of hospital mortality and prolonged hospitalization.

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Risk of sepsis, respiratory infections, and kidney or other genitourinary (GU) infections in patients with chronic hypoparathyroidism (HypoPT): a retrospective cohort study

Endocrine Abstracts ◽

10.1530/endoabs.63.oc1.4 ◽

2019 ◽

Author(s):

Kristina Chen ◽

Gary Curhan ◽

Elvira Gosmanova ◽

Fan Mu ◽

Allison Briggs ◽

...

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Respiratory Infections ◽

Chronic Hypoparathyroidism

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Association between Afterhours Discharge from the Intensive Care Unit and Hospital Mortality: A Multi-Centre Retrospective Cohort Study

10.21203/rs.3.rs-52238/v1 ◽

2020 ◽

Author(s):

Adam Hall ◽

Xioaming Wang ◽

Danny J Zuege ◽

Dawn Opgenorth ◽

Damon C Scales ◽

...

Keyword(s):

Intensive Care Unit ◽

Cohort Study ◽

Intensive Care ◽

Hospital Mortality ◽

Organ Dysfunction ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Potential Effect ◽

Mixed Effect ◽

Size Type

Abstract Background: There is conflicting evidence on the association between afterhours discharge from the intensive care unit (ICU) and hospital mortality. We examined the effects of afterhours discharge, including the potential effect of residual organ dysfunction, on hospital mortality in a large integrated health region. Methods: We performed a multi-centre retrospective cohort study of 10,463 adults discharged from nine mixed medical/surgical ICUs in Alberta from June 2012 to December 2014. We applied a two-stage modelling strategy to investigate the association between afterhours discharge (19:00h to 07:59h) and post-ICU hospital mortality. We applied mixed-effect multi-variable linear regression to assess the relationship between discharge organ dysfunction and afterhours discharge. We then applied mixed-effect multi-variable logistic regression to evaluate the direct, indirect and integrated associations of afterhours discharge on hospital mortality and hospitalization duration. Results: Of 10,463 patients, 23.7% (n=2,480) were discharged afterhours, of which 27.4% occurred on a holiday or weekend. This varied significantly by ICU size, type, and site. Patients discharged afterhours were more likely medical admissions, had greater multi-morbidity and illness acuity. Greater SOFA score in the 72 hours prior to discharge was not associated with afterhours discharge; however, was associated with hospital mortality (adjusted-OR 1.23; 95%CI,1.18-1.28). Afterhours discharge was associated with higher hospital mortality (adjusted-OR 1.19; 95%CI, 1.01-1.39), increased hospital stay (adjusted-OR 1.10; 95%CI,1.09-1.11) and increased post-ICU stay (adjusted-OR 1.16; 95%CI,1.14-1.17).Conclusions: Afterhours discharge is common, occurring in 1 in 4 discharges, and is widely variable across ICUs. Patients discharged afterhours have greater risk of hospital mortality and prolonged hospitalization.

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